FEASIBILITY AND VERSATILITY OF PEDICLED BUCCAL FATPAD AS AN ADJUNCT IN CLEFT PALATE SURGERY – A CLINICAL STUDY

Dr. Anand Mangalgi, Dr. Viquar Ahmed, Dr. Sowmya T.*, Nagesh Ingleshwar and Dr. Supriya Patil

ABSTRACT

Background: The use of a pedicled buccal fat pad graft to cover palatal osseous defects and to prevent or repair fistulas has gained popularity in recent years. Buccal pad fat graft is a useful, easy and uncomplicated alternative method for the reconstruction of small to medium-sized defects of the oral hard and soft tissue. The objective of this study was to test the feasibility and efficacy of pedicled buccal fat pad graft as an adjunct in cleft palate surgery. Materials and methods: In this study, 10 patients with primary and secondary cleft palate defects were selected. The patients underwent primary palatoplasty or redo palatoplasty for palatal fistula repair using pedicled buccal fat pad graft as an adjunct. All patients were followed up for minimum of 3 months at intervals of 3 days, 1 week, 1 month and 3 months, to evaluate the postoperative healing, infection, dehiscence, herniation of buccal fat pad, fistula and scar formation. Results: In all the patients, mild pain was present on the 3rd post-operative day which subsided by the end of 1 week post-operatively. Infection of the graft was observed in 1 patient one week post-operatively, which resolved on continuing antibiotics for 3 days and good oral hygiene maintenance. Dehiscence and herniation of buccal fat pad was not noted in any of the patients. 2 patients with bilateral cleft palate repair presented with fistula 1 month post-operatively.Scars were classified as discrete (thin incision line without fibrosis), fibrosed (visible discrete fibrosis on the incision line), hypertrophic. In 7 patients, healing was excellent with thin, discrete scar formation. 2 patients developed fibrosed scar and 1 patient developed hypertrophic scar 3 months post-operatively. Conclusion: Pedicled buccal fat pad graft as an adjunct in cleft palate surgeries is safe, and reliable alternative for tissue deficit repair in cleft palate surgery.

Keywords: Cleft palate, pedicled buccal fat pad, palatoplasty.